Fabio Bagante1, Gaya Spolverato1, Matthew Weiss2, Sorin Alexandrescu3, Hugo P Marques4, Luca Aldrighetti5, Shishir K Maithel6, Carlo Pulitano7, Todd W Bauer8, Feng Shen9, George A Poultsides10, Oliver Soubrane11, Guillaume Martel12, B Groot Koerkamp13, Alfredo Guglielmi1, Endo Itaru14, Timothy M Pawlik15,16. 1. Department of Surgery, University of Verona, Verona, Italy. 2. Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA. 3. Department of Surgery, Fundeni Clinical Institute, Bucharest, Romania. 4. Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal. 5. Department of Surgery, Ospedale San Raffaele, Milan, Italy. 6. Department of Surgery, Emory University, Atlanta, GA, USA. 7. Department of Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia. 8. Department of Surgery, University of Virginia, Charlottesville, VA, USA. 9. Department of Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China. 10. Department of Surgery, Stanford University, Stanford, CA, USA. 11. Department of Hepatobiliopancreatic Surgery and Liver Transplantation, AP-HP, Beaujon Hospital, Clichy, France. 12. Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa, ON, Canada. 13. Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands. 14. Gastroenterological Surgery Division, Yokohama City University School of Medicine, Yokohama, Japan. 15. Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA. tim.pawlik@osumc.edu. 16. Department of Surgery, The Urban Meyer III and Shelley Meyer Chair in Cancer Research, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 670, Columbus, OH, 43210, USA. tim.pawlik@osumc.edu.
Abstract
BACKGROUND: The influence of morphological status on the long-term outcome of patients undergoing liver resection for intrahepatic cholangiocarcinoma (ICC) is poorly defined. We sought to study the impact of morphological status on overall survival (OS) of patients undergoing curative-intent resection for ICC. METHODS: A total of 1083 patients who underwent liver resection for ICC between 1990 and 2015 were identified. Data on clinicopathological characteristics, operative details, and morphological status were recorded and analyzed. A propensity score-matched analysis was performed to reduce confounding biases. RESULTS: Among 1083 patients, 941(86.9%) had a mass-forming (MF) or intraductal-growth (IG) type, while 142 (13.1%) had a periductal-infiltrating (PI) or MF with PI components (MF + PI) ICC. Patients with an MF/IG ICC had a 5-year OS of 41.8% (95% confidence interval [CI] 37.7-45.9) compared with 25.5% (95% CI 17.3-34.4) for patients with a PI/MF + PI (p < 0.001). Morphological type was found to be an independent predictor of OS as patients with a PI/MF + PI ICC had a higher hazard of death (hazard ratio [HR] 1.42, 95% CI 1.11-1.82; p = 0.006) compared with patients who had an MF/IG ICC. Compared with T1a-T1b-T2 MF/IG tumors, T1a-T1b-T2 PI/MF + PI and T3-T4 PI/MF + PI tumors were associated with an increased risk of death (HR 1.47 vs. 3.59). Conversely, patients with T3-T4 MF/IG tumors had a similar risk of death compared with T1a-T1b-T2 MF/IG patients (p = 0.95). CONCLUSION: Among patients undergoing curative-intent resection of ICC, morphological status was a predictor of long-term outcome. Patients with PI or MF + PI ICC had an approximately 45% increased risk of death long-term compared with patients who had an MF or IG ICC.
BACKGROUND: The influence of morphological status on the long-term outcome of patients undergoing liver resection for intrahepatic cholangiocarcinoma (ICC) is poorly defined. We sought to study the impact of morphological status on overall survival (OS) of patients undergoing curative-intent resection for ICC. METHODS: A total of 1083 patients who underwent liver resection for ICC between 1990 and 2015 were identified. Data on clinicopathological characteristics, operative details, and morphological status were recorded and analyzed. A propensity score-matched analysis was performed to reduce confounding biases. RESULTS: Among 1083 patients, 941(86.9%) had a mass-forming (MF) or intraductal-growth (IG) type, while 142 (13.1%) had a periductal-infiltrating (PI) or MF with PI components (MF + PI) ICC. Patients with an MF/IG ICC had a 5-year OS of 41.8% (95% confidence interval [CI] 37.7-45.9) compared with 25.5% (95% CI 17.3-34.4) for patients with a PI/MF + PI (p < 0.001). Morphological type was found to be an independent predictor of OS as patients with a PI/MF + PI ICC had a higher hazard of death (hazard ratio [HR] 1.42, 95% CI 1.11-1.82; p = 0.006) compared with patients who had an MF/IG ICC. Compared with T1a-T1b-T2 MF/IG tumors, T1a-T1b-T2 PI/MF + PI and T3-T4 PI/MF + PI tumors were associated with an increased risk of death (HR 1.47 vs. 3.59). Conversely, patients with T3-T4 MF/IG tumors had a similar risk of death compared with T1a-T1b-T2 MF/IG patients (p = 0.95). CONCLUSION: Among patients undergoing curative-intent resection of ICC, morphological status was a predictor of long-term outcome. Patients with PI or MF + PI ICC had an approximately 45% increased risk of death long-term compared with patients who had an MF or IG ICC.
Authors: Xu-Feng Zhang; Eliza W Beal; Jeffery Chakedis; Qinyu Chen; Yi Lv; Cecilia G Ethun; Ahmed Salem; Sharon M Weber; Thuy Tran; George Poultsides; Andre Y Son; Ioannis Hatzaras; Linda Jin; Ryan C Fields; Stefan Buettner; Charles Scoggins; Robert C G Martin; Chelsea A Isom; Kamron Idrees; Harveshp D Mogal; Perry Shen; Shishir K Maithel; Carl R Schmidt; Timothy M Pawlik Journal: World J Surg Date: 2018-09 Impact factor: 3.352
Authors: Fabio Bagante; Gaya Spolverato; Matthew Weiss; Sorin Alexandrescu; Hugo P Marques; Luca Aldrighetti; Shishir K Maithel; Carlo Pulitano; Todd W Bauer; Feng Shen; George A Poultsides; Oliver Soubrane; Guillaume Martel; B Groot Koerkamp; Alfredo Guglielmi; Endo Itaru; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2017-08-24 Impact factor: 3.452
Authors: H P Neeff; P A Holzner; M Menzel; P Bronsert; A Klock; S A Lang; S Fichtner-Feigl; U T Hopt; F Makowiec Journal: Chirurg Date: 2018-05 Impact factor: 0.955
Authors: Xu-Feng Zhang; Jeffery Chakedis; Fabio Bagante; Eliza W Beal; Yi Lv; Matthew Weiss; Irinel Popescu; Hugo P Marques; Luca Aldrighetti; Shishir K Maithel; Carlo Pulitano; Todd W Bauer; Feng Shen; George A Poultsides; Oliver Soubrane; Guillaume Martel; B Groot Koerkamp; Alfredo Guglielmi; Endo Itaru; Timothy M Pawlik Journal: World J Surg Date: 2018-03 Impact factor: 3.352
Authors: Daniel R Waisberg; Rafael S Pinheiro; Lucas S Nacif; Vinicius Rocha-Santos; Rodrigo B Martino; Rubens M Arantes; Liliana Ducatti; Quirino Lai; Wellington Andraus; Luiz C D'Albuquerque Journal: Transl Gastroenterol Hepatol Date: 2018-09-12
Authors: A Nickkholgh; O Ghamarnejad; E Khajeh; P Tinoush; T Bruckner; Y Kulu; M Mieth; B Goeppert; S Roessler; K H Weiss; K Hoffmann; M W Büchler; A Mehrabi Journal: BJS Open Date: 2019-09-10